Lichen Planus and Lichen Sclerosus

Question 1

Features of lichen planus

Answer 1

• itchy, papular rash
• palms, soles, genitalia and flexor surfaces of arms
• polygonal with ‘white-lines’ (Wickham’s striae)
  -white-lace pattern on the buccal mucosa
• thinning of nail plate, longitudinal ridging
• may exhibit Koebner phenomenon (lesions appear at site of trauma)

Question 2

What drugs can cause lichenoid drug eruptions?

Answer 2

gold
quinine
thiazides

Question 3

Management of lichen planus

Answer 3

• potent topical steroids
• benzydamine mouthwash
• oral steroids or immunosuppression

Question 4

What is lichen sclerosus?

Answer 4

Inflammatory condition affecting genitalia
more common in older females

Question 5

Features of lichen sclerosus

Answer 5

• white patches that may scar
• itch
• pain during intercourse or urination

Question 6

Management of lichen sclerosus

Answer 6

Topical steroids and emollients

Question 7

Why is follow-up important in lichen sclerosus

Answer 7

increased risk of vulval cancer